caa a22 4500 605495130 CHVBK 20210128100529.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s00261-014-0144-7 doi (NATIONALLICENCE)springer-10.1007/s00261-014-0144-7 Clinical characteristics and imaging features of small bowel adenocarcinomas in Crohn's disease [Elektronische Daten] [Nicholas Weber, Joel Fletcher, Jeff Fidler, John Barlow, Shiv Pruthi, Edward Loftus Jr., Darrell Pardi, Thomas Smyrk, Brenda Becker, Shabana Pasha, David Bruining] Purpose: Small bowel adenocarcinoma is uncommon in patients with Crohn's disease but has an extremely poor prognosis. There is a paucity of data on the clinical characteristics and radiologic features of this entity. We sought to update our institutional experience with small bowel adenocarcinoma occurring in the setting of Crohn's disease and to systematically re-examine pre-operative imaging findings. Methods: Medical records were abstracted to identify all patients with Crohn's disease and small bowel adenocarcinoma who were evaluated at Mayo Clinic, Rochester, Minnesota and Mayo Clinic, Scottsdale, Arizona between 1976 and 2012. Clinical, demographic, and outcomes data were obtained for each patient. Pre-diagnosis radiologic imaging was re-evaluated by two gastrointestinal radiologists. Results: Thirty-four patients (21 males) were identified. Median ages at Crohn's disease and cancer diagnoses were 22.4 and 52.9years, respectively. Median follow-up after cancer diagnosis was 272.0days; 22 patients (64.7%) had persistent or recurrent adenocarcinoma at last follow-up. 1- and 2-year mortality rates were 29.6% and 48.0%. Pre-operative imaging studies were available for re-review in 14 cases. Features concerning for malignancy included annular mass, nodularity at the extraluminal margins of the mass, and perforation. Nearly all tumors arose in regions of chronic inflammation and caused luminal narrowing with pre-stenotic dilatation. Conclusions: Small bowel adenocarcinoma is rare in patients with Crohn's disease but results in significant mortality. CT or MR imaging findings can be suggestive of the pre-operative diagnosis, but it is usually diagnosed at an advanced stage with laparotomy. Springer Science+Business Media New York, 2014 Adenocarcinoma nationallicence Crohn's disease nationallicence CT enterography (CTE) nationallicence MR enterography (MRE) nationallicence CT : Computed tomography nationallicence CTE : CT enterography nationallicence IBD : Inflammatory bowel disease nationallicence MRE : Magnetic resonance enterography nationallicence Weber Nicholas Division of Gastroenterology & Hepatology, Mayo Clinic College of Medicine, 200 First Street, SW, 55905, Rochester, MN, USA aut Fletcher Joel Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN, USA aut Fidler Jeff Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN, USA aut Barlow John Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN, USA aut Pruthi Shiv Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN, USA aut Loftus Jr. Edward Division of Gastroenterology & Hepatology, Mayo Clinic College of Medicine, 200 First Street, SW, 55905, Rochester, MN, USA aut Pardi Darrell Division of Gastroenterology & Hepatology, Mayo Clinic College of Medicine, 200 First Street, SW, 55905, Rochester, MN, USA aut Smyrk Thomas Department of Pathology, Mayo Clinic College of Medicine, Rochester, MN, USA aut Becker Brenda Division of Gastroenterology & Hepatology, Mayo Clinic College of Medicine, 200 First Street, SW, 55905, Rochester, MN, USA aut Pasha Shabana Division of Gastroenterology & Hepatology, Mayo Clinic College of Medicine, Scottsdale, AZ, USA aut Bruining David Division of Gastroenterology & Hepatology, Mayo Clinic College of Medicine, 200 First Street, SW, 55905, Rochester, MN, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/5(2015-06-01), 1060-1067 0942-8925 40:5<1060 2015 40 261 https://doi.org/10.1007/s00261-014-0144-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-014-0144-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Weber Nicholas Division of Gastroenterology & Hepatology, Mayo Clinic College of Medicine, 200 First Street, SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Fletcher Joel Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN, USA aut NATIONALLICENCE 700 1- Fidler Jeff Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN, USA aut NATIONALLICENCE 700 1- Barlow John Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN, USA aut NATIONALLICENCE 700 1- Pruthi Shiv Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN, USA aut NATIONALLICENCE 700 1- Loftus Jr Edward Division of Gastroenterology & Hepatology, Mayo Clinic College of Medicine, 200 First Street, SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Pardi Darrell Division of Gastroenterology & Hepatology, Mayo Clinic College of Medicine, 200 First Street, SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Smyrk Thomas Department of Pathology, Mayo Clinic College of Medicine, Rochester, MN, USA aut NATIONALLICENCE 700 1- Becker Brenda Division of Gastroenterology & Hepatology, Mayo Clinic College of Medicine, 200 First Street, SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 700 1- Pasha Shabana Division of Gastroenterology & Hepatology, Mayo Clinic College of Medicine, Scottsdale, AZ, USA aut NATIONALLICENCE 700 1- Bruining David Division of Gastroenterology & Hepatology, Mayo Clinic College of Medicine, 200 First Street, SW, 55905, Rochester, MN, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/5(2015-06-01), 1060-1067 0942-8925 40:5<1060 2015 40 261